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Author
Topic: Loss of libido (Read 8244 times)

Can anyone comment on this? I've read it may be somewhat common, but I've never personally known anyone other than me to experience this. I've been on meds about 6 months and I have no sex drive at all. I am male 38 years old. Thanks, Sam in 'bama

Loss of libido (or sexual dysfunction generally) could be caused by a number of different factors, either individually or in combination. Could be that:

1. Undiagnosed or untreated depression. Loss of libido is in fact one of the diagnostic criteria for determining whether a person is depressed or not. Anxiety and guilt can also be "downers."

2. Hypogonadism -- low levels of testosterone (caused either by the meds you take or HIV itself).

3. ARVs. There's been some, inconclusive, research to suggest that anti-retrovirals are associated with sexual dysfunction. Out of three studies published in JAIDS in 2002, two found some association between protease inhibitors and sexual dysfunction (one of these studies found ritonavir, Norvir, to be the biggest "culprit"), the third didn't find a link.

4. Use of certain anti-depressants or drugs used to treat high BP and cholesterol.

5. Excessive use of recreational drugs and alcohol.

So much for the possible causes. Sorry to hear about your problem. I'm assuming (perhaps incorrectly) that the loss of libido occurred only after you tested positive and started taking meds. Have you spoken to your doctor about it, or a therapist? That's a first step; and I'd also suggest that you get your testosterone levels checked (total as well as free) -- if they're low or low-normal (within the parameters for your age), supplementation is an option.

Here's hoping you have constant erections, and a rampaging sex life, soon enough.

Jay

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Her finely-touched spirit had still its fine issues, though they were not widely visible. Her full nature, like that river of which Cyrus broke the strength, spent itself in channels which had no great name on the earth. But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.

Sorry to hear about the problem, but I've been there dozens of times over the years. One thing that really works for me is to supplement my Testosterone each week, because even though I test at a normal level, my normal level is way too low for me to function sexually. Ask your doc if he/she has done a test for test and even if you test normal, maybe try supplementing for a month to see if it makes a difference.

Would you mind sharing the specifics of your normal level and weekly supplementation dose? Thanks.

Jay

« Last Edit: July 31, 2006, 01:33:16 AM by lydgate »

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Her finely-touched spirit had still its fine issues, though they were not widely visible. Her full nature, like that river of which Cyrus broke the strength, spent itself in channels which had no great name on the earth. But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.

First let me thank you all for your replies; in my 8 months of diagnosis and treatment, this is where I turn first when I have a question or when I feel alone.

To Lydgate: You assumed correctly. I began losing my libido since diagnosis and beginning meds (both happened within a month of each other because of my high vl and low cd4 count), and it is now completely gone and has been since about two months after I was diagnosed / began meds. I feel like a Eunuch. I will talk to my doc about it and try to get it treated. The irony is that I've been pretty up about my good numbers lately.

Granted my numbers look really high, but the difference in my energy and libido are impressive. Some doctors will resist using test as a supplement, but you won't know unless you try and it's a pretty cheap way to get some extra energy.

Test comes in a few variations for injecting or a gel like Androgel that you would use every day. If you take your test intramuscular, generally once per week, you may experience peaks and valleys in your levels, because you will get a very high level right after the shot and this will then diminish until your next shot 7 days later. Some find the daily gel works better for them, because it delivers a more steady dose, but all that matters is you find something that works for you.

Test also comes in different strengths and is referenced as either 100mg or 200mg per mL. I use the 200mg and I take 1mL per week and even do the shots myself. I can't stress how much test has improved my quality of life and you could always start by just having the doc give you one shot and then see how you feel in the next week.

And Sam, when you talk with your doc, ask them about both the meds and the possibility that you are depressed or suffer from anxiety. Strange as it sounds, sometimes using a mild form of anti-depressent/anxiety drug can make a world of difference. You also don't have to take the drugs forever and you may just need a little help to get you over these first few months. Keep asking and demanding treatment until you find something that works. You have every right to the best quality of life that you can attain and if your doc won't do it, then find one who will.

Hi! I have the same problem: I was diagnosed in September and started to take pills in October. Now in almost sexually died The situtuation is getting worse...My doc thought that it is a mental thing???Yes, I have taken paroxetin daily 2 years now, but my sexual drive have disapperad within 6 months....My doc said that they must check my testosterone level next time when they take lab tests.Situation is awful- I`m only 30 years old male and i feel like an old lady

Yeap, same thing here. Go days and even weeks without thinking about it. When I do, cannot get the deed finished so to speak. Had the doc check my testostorone levels, they are normal. So, what next??? Good question.

There are definitely those who believe that even mid-normal levels of testosterone aren't sufficient for men who are positive. I was in touch with Michael Mooney (co-author of Built to Survive) and Dr. Judith Rabkin at Columbia about this. Both expressed frustration at the medical community's fear-based approach to testosterone/anabolic treatment. Many, if not most, doctors will refuse to prescribe test. if your levels are mid-normal and above. I felt tired, blah, apathetic, had no libido whatsover; my free test. levels were around 500. I went armed to the teeth with studies to my HIV clinic. Flat no. Tried again, with more research, and also asking what's the harm in trying it out for a month. Still, a big NO.

Switched docs, went to private clinic in a big city. The doctor said, good god, you definitely ought to try supplementation. I did, and my quality of life is significantly better. I'm not saying that every poz man with normal levels should supplement with testosterone. But Joe's story, and mine, indicates that it's worth investigating as an option, if there's an idiopathic problem with libido, mild depression, fatigue. (And let's not forget that Joe has been positive for a relatively long time, I've been poz for under a year; that Joe's on meds, I'm not. Despite these differences, the testosterone made a big q-of-l impact on both of us.)

A couple of extracts from an email from Michael Mooney:

(1) "Your testostone at 500 + is not enough for you to experience normal quality of life. In our book we detail Dr. Judith Rabkin's studies showing that HIV positive men can need testosterone measurements that are at and over the top of the normal scale to get normal quality of life. This is because of hormonal resistance, which is typical of the pathology."

(2) "10 grams of Androgel is still a very low dose, one that we have seen have little or no effect on many HIV+ men. Injections of 200 mg per week would be more in keeping with what most HIV+ men find works best. Nelson uses doses in that range, and we both know many others who do. 100 mg per week would still produce more benefit than 10 g of Androgel."

We've written several others but this should suffice to make it clear that the majority of participants derived great benefit from treatment and the majority were NOT technically hypogonadal as defined by the laboratory reference range."

(2) "I think you have a case, or as lawyers say, a brief, and I'll try to help you get access to what could very well be what you need. I'd be happy to see you if you're in NYC and I do not charge for consultations when you come to my office at New York State Psychiatric Institute. Part of the job as I see it."

Well, this post has turned out to be longer than I'd expected. Hope it helps or clarifies a few things. Finally, if anyone goes the IM route, I'd strongly suggest weekly shots rather than every two weeks or even (!) every three weeks, to minimize the peak-trough effect.

Jay

« Last Edit: August 01, 2006, 02:39:50 AM by lydgate »

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Her finely-touched spirit had still its fine issues, though they were not widely visible. Her full nature, like that river of which Cyrus broke the strength, spent itself in channels which had no great name on the earth. But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.

Sam... I think you have discovered that you are far from ALONE when it comes to this subject. I dare say we have all suffered from a lack of interest whether it be psychological or physiological. It takes time for us to accept our diagnosis and the impact it has on our lives. If it really bothers you...I would check with your doctor or seek counseling...either way you deserve to have the best that life has to offer and that includes every aspect. Be proactive...be well

Man, I'm glad this thread is here. I thought I was the only one having that problem. When I was diagnosed two years ago, I fell into a major depression. Haven't had an erection since. Although I'm currently in a place where I don't want to even touch the gene pool, I do plan on moving in a few months to be a little closer to "our people".

Wow...all these short term folks... rest assured, life aint that bad...I'm poz for 29 years. I have not had a 'libido' problem all these years until about 10 months when I have had some kind of intestinal infection which has cost me 25 of my 125 pounds. They cant find anything but im no better. It hasnt been a problem of performing, I have no desire at all. Im trying androgel to no avail after 3 months. Its not fun but I will find a solution.

I just got an e-mail from AIDSmeds, and was elated to see some of the topics being discussed.

I also have experience a drastic drop in my libido, and though I've had several tests to check my testosterone levels, which the doctor says is normal, I still have not had that drive I used to have. At 42, I was still sexually active(married for 13 years at that time), and was having an active sex life. Now, it is work to even maintain an erection, to say the least. I've expressed my concerns to my doctor, and she seems not to really be concerned about this.

I am glad to finally learn that I am not by myself with this issue. I've found myself becoming very angry about this in more ways than you can imagine. I've even resorted to several alternatives to help this, but it is only short lasting. So, I guess I really need to know what to do about this, to restore some desire and function.

NEW YORK (Reuters) -- While there's a statistical link between men's sex drive and their testosterone levels, in practice there's little meaningful difference in testosterone levels between men with low libido and those with high libido, researchers report.

Dr. Thomas G. Travison, from the New England Research Institutes in Watertown, Massachusetts, and his associates evaluated data from the Massachusetts Male Aging Study, and report their findings in the Journal of Clinical Endocrinology and Metabolism.

Between 1987 and 1989, a total of 1,632 men ages 40 to 70 years were enrolled in the study. They were assessed at the outset and two more times approximately 9 and 15 years later, when 922 and 623 men, respectively, were available.

At each time point, the men completed a self-administered questionnaire asking about the frequency of sexual desire and of sexual thoughts and fantasies, and their hormone levels were measured.

Men with scores of less than 7 points out of a total 14 were classified as having a low libido, which included 19 percent of men at the start of the study, 23 percent after 9 years, and 28 percent at 15 years.

Travison's team reports that, overall, libido was significantly associated with testosterone levels. However, the difference in testosterone levels between participants with low libido and those with high libido was small and "inconsequential."

Looked at the other way, a low libido did not mean a man was particularly likely to have low levels of testosterone.

Therefore, the researchers conclude that if a man complains of reduced libido, it cannot always be interpreted as a sign of testosterone deficiency.

Hi, I just wanted to put my two cents in on this subject. I have living with AIDS for over 10 years now(diagnosed AIDS in Feb.'96), and have been dealing with sexual problems ever since. I have been reading the other replies mentioning testosterone levels and how they effect the libido. While it is true that they can and do effect the libido, it has been my personal experience that testosterone levels are not the only cause of libido loss. When I started taking meds, I noticed a serious drop off in libido. I found that the stress and stigma of my AIDS diagnosis had been a huge factor in my desire to have a sexual life. On one hand I felt pretty low in my self esteem about being poz. Later, as I began to accept my diagnosis more thoroughly, I found that I was once again beginning to fantasize about sex. Although, as I later found out, the meds had by then taken over my abilities to function sexually. I went for the testosterone level checks upon talking to my doctor about this problem. when the tests came back, they showed that I had twice the testosterone levels of a normal, healthy man of any age. This later proved to be a problem with some of my meds, as it caused me to be susceptible to experiencing rage. By this time I had knocked out two of the four main factors that most of us have to deal with when it comes to libido. The third factor is exhaustion. A lot of the time, I am dealing with family matters,(I am a married bisexual male of 45 years of age.) and I find that I am usually too exhausted to even try to have sex with my wife. With the daily stresses that I deal with, sex is often the thing that suffers the most from my hectic schedule. I am, by trade, a Master Automotive Technician(ASE Certified). While I am trying to build my own shop(lately by hand), I have to deal with keeping several vehicles running for family and friends. Leaving very little time for much else. The fourth factor is, of course, our meds. These have varying side effects with varying degrees of affectation. Some of them can seem to deplete any thought of even wanting to have sex for many different reasons. Some reasons include the way they make your body feel(e.g., general feeling of malaise, stomach discomfort, high blood pressure, etc...), the way they can effect your mind when they reach it(e.g.,depression, nightmares affecting sleep patterns,etc...), and your spiritual well-being(e.g. that low feeling you get when taking your meds reminding you of your status, your self-esteem, etc...). Over the years, I have dealt with all of these things and have managed to put them all in their proper perspective. It hasn't been easy, but I have, just the same, managed. The meds have been the hardest to overcome without other "little helpers". When I have wanted sex, I have often found that my meds have interfered with my physical functioning. Because sometimes I try and feel that "he" isn't always there for me. Not that I have lost all voluntary function, I just need a little help from Viagra every now and then. And just a little, I break a tablet down to the size dose I feel I will need to get the job done, you know? So, besides testosterone, check for high blood pressure, and hypertension. Ask your doc about other factors that can lead to loss of libido and functioning. This is, by far, not an uncommon problem with men with HIV. But it is often the part of our lives that suffers the most because of fear of discussion. Bob

I have been on meds since 1992, starting with AZT. Like so many of you, my sex life has dropped to zero interest. Even if an erection is achieved, it usually fails to last beyond a minute or two, and ejaculation takes forever. I did get the test for testosterone levels, and my doctor wouldn't put me on anything because the levels were all "normal". My HIV doctor suggested I try Viagra or one of the other ED drugs. That helped with the erection but not with the desire. I have printed out the comments y'all have made and plan to take them with me when I go back to the doctor for my next appointment. At least now I have some ammunition to back me up when I ask for testosterone treatment.

I was just recently diagnosed (April 06). My numbers are good and I am not on meds but I:

a) feel tired all the timeb) have no sexual desire whatsoever

After reading soooo much about this I gathered it was just part of normal HIV living.

After speaking to my Dr...and taking Testosterone tests, we assumed it was just depression....Having lost a couple of pounds, I feel scared that this can lead to more significant problems if left untreated.

So I have decided to try anti-depresants for a while (Ceprasil)...Will let everyone know in a couple of weeks if it changed anything.

What a great place to find people just like you...I read these posts just to feel comfortable in knowing that no matter what, someone prolly has gone through it before me and was able to get through it write about it...

I wonder if those experiencing libido problems are in relationships (that are/have been sexually active) or are single. The reason I bring this up is that, while I've got a partner, I can imagine how stressful and disappointing it would be to be seeking a (sexual) partner and know that I've got this bug. I wonder if this stress is contributing to the loss of libido.

I was having anxiety/ panic attacks and my Dr. prescribed Prozac for me. It's helping a lot, but it cut my libido WAY down. It hasn't really been a problem, since the Prozac's made me feel so much better in general. It's not that I can't function, I just don't have as much drive. I've always had a very strong sex drive, so it's been a change. It's still great when we do have sex; we just don't have it as much. It bothered me more at first, but feeling so much better has been worth (to me) a reduction in libido. Having said that, I've been 'practicing' with myself... to try and get back into it more. You know what they say about 'use it or lose it'... I wonder how much of this problem is caused by our emotions. Also, age in general has a big effect on ED.

One thing that's cool about this topic... look how many new members have posted! That should tell us that this a fairly common problem and a major concern to those bothered by it.

Wow, I just came across you all postings, "loss of libido". I have been going crazy about not being able to function with regular sex partners. I am em brassed and it bother me to the point, I will not take their phone calls anymore. I fell on several occasions to get off (excuse the term) and I couldn't explain myself. My sex partners don't know I am on meds... but I make sure we practices safe sex, that way I don't feel I have to tell them I am HIV+. I was reading above where someone mention this to could have something to do with it.....

I been on meds for 2 1/2 months sustiva and truvada, and I to have noticed the change with my sexual desires these days. I had a good idea,that it was the meds or something to do with depression... I was puzzled and didn't understand what was going on with me and just tried to go with it. It really bothering me now.... my sperm is not creamy anymore it more like watery.... (sorry to be so graphic)..... when I masterbate..... :-(

I will be seeing my doctor on the 18th and this will be one of the topic we will discuss, testosterone.....That why I like this site so MUCH!

THANKS Everyone!!

max[/size][/size]

« Last Edit: August 03, 2006, 09:32:54 PM by OakMax1 »

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Go with it and KEEP MOVIN! Life is good today and I am glad to be here

donwolf

you seem to have asked the question of the decade. Seems there should be a lot more answers w/certainty since this appears to be a universal issue. I too have had/have this issue, I have been + for 15 years, on meds since 1992. Been with my partner for the same length of time and he as well was diagnosed at the same time. We wanted to get tested prior to starting our relationship and unfortunately did not expect the results, but we are still together after all this time. I say the intimacy encounters are very low. 5 or maybe 6 times a year it happens. I do believe it is a combination of many factors, Meds & side effect (especially the GI symptoms), incredible fatigue, the disease, Loss of spontaneity, I find now that I need the for-play more than ever now to feel intimate. the nurturing gentleness and that can often move to the passion of the actually sexual act. last but not lease to be completely honest with any sexual partners you may have is important, if you are not hiding anything, there is no hidden stress added to it.

I will take your advice, but I find it so hard to just tell a guy I am HIV+, but I am learning everyday and will add this to my changing new life. It does remove a lot of stress. It will be hard to do but oh well... keep it real and moving in the right direction!

Thanks and guess what MY sex drive is BACK!!!!!!

Have a great weekend!

max

« Last Edit: August 08, 2006, 08:15:53 PM by OakMax1 »

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Go with it and KEEP MOVIN! Life is good today and I am glad to be here

Well... given your recent diagnosis and nearly immediate start of meds, it has to have taken a mental toll or you're not human. I'm guessing you became infected via sex.... so given the bomb that was just dropped on you, I think it's only natural to NOT want to have anything to do with sex. At least that's how I felt. I'm still celebate 4 years later but have thought about sex again... but haven't tried it because I don't believe I am in the proper state of mind to control my behavior, so better just to not go there.

There are no stupid questions, only stupid people, but does loss of libido mean you aren't interested in sex with a partner, as well as masturbation? Just curious if people are not interested in sex with others, but enjoying the personal pleasures of ones body, but still consider this loss of libido?

You are definitely NOT alone. I just found out I was positive in April of this year, and until about a month ago, I had NO desire whatsoever to have sex with another person. Thankfully, that's passed with me.

I remember when first taking care of myself after finding out, I looked at my semen, and I thought, "wow, this could kill someone." It was certainly not an inspiring thought.

It should pass in time, but if not, the wealth of information already given will definitely come in handy.

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"Love is always patient and kind. It is never jealous. Love is never boastful nor conceited. It is never rude or selfish. It does not take offense and is not resentful. Love takes no pleasure in other people's sins, but delights in the truth. It is always ready to excuse, to trust, to hope, and to endure whatever comes." - 1 Corinthians 13:4-7, adaptation in A Walk To Remember